When a child suffers an accidental injury, families are suddenly faced with fears about the child's survival and uncertainty about the child's future. Even school-age children with mild traumatic brain injuries (TBI) experience deficits in attention and memory that affect every aspect of their lives. Effects of the stress of parenting a child with continuing but subtle deficits on parent mental health, parent-child, and family relationships are unknown. The purpose of this longitudinal nursing study is to describe the impact of TBI severity, resistance resources, and parental appraisal on adaptation of preschool children with TBI and their parent(s) and on quality of parent-child and family relationships during the first year. Families (N=420) with a 3- to 6-year-old hospitalized child with an injury where a blow to the head was likely and either a history of loss of consciousness, symptoms of head injury in children, x-ray or CT scan suggestive of TBI will be recruited. Other inclusion criteria are child living with at least one parent before the accident, and parent(s) able to understand spoken English. Exclusion criteria are: severe pre-existing cognitive deficits, pre-existing chronic illness, previous hospitalization other than at birth, living in a foster home before admission, being evaluated with brain criteria, injury suspected to be due to child abuse, parent(s) hospitalized concurrently or death of a parent in the accident. A conceptual model based on the Resiliency Model of Family stress, Adjustment, and Adaptation guides the study's design and analysis. Data will be collected in the hospital at 24 hours after admission, within 24 hours before hospital discharge, and in the family's home at 2 weeks, 3, 6, and 12 months after discharge. The proposed study will provide data on behavioral, cognitive, memory, motor, and functional outcomes for preschoolers and effects of the child's injury and outcomes on parental mental health and indirectly on parent-child and family relationships in the first year after hospital discharge. Describing the frequency of problems and identifying factors that affect the rate of change in child, parent, and family outcomes is the first step toward successfully guiding families through the early recovery period in a way that promotes optimal child functioning, parent mental health, and family stability. If nursing research and care can facilitate achieving these objectives, burden on health care, educational, and family systems will be reduced.